Public and Teaching Hospital Preservation Act

HR 4355/S 2460, To impose moratorium on certain Medicaid payment restrictions, entire bill HR 3533, Public and Teaching Hospitals Preservation Act, Entire Bill HR 5613, Protecting the Medicaid Safety Net Act of 2008, Entire Bill S 2819, Economical Recovery in Heatlh Care Act 2008, Entire Bill HR 5942, National Trauma Center Stablizations Act, Entire Bill, HR 5998, Medicaid SCHIP Directive, entire bill HR 4105 Medicare Recovery in Audit Contractor Program Moratorium Act od 2007, entire bill, HR 1424/ S 558, Paul Wellstone Mental Health and Addictions Equity Act of 2007, Section 206 Limitations on Physcian Ownership of Hosptials. HR 1174, Health Hospital Act of 2007, entire bill, S 1842/HR/2122, Safe Nursing and Patient Care Act of 2007, entire bill. Social Security Income Days- Disproportionate Share Hospitals Payments, Miscalulatios of SSI days by CMS. HR 6357, to amend the Public Health Service Act.

Client expense: $9,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Hr 4355/S 2460 - To impose moratorium on certain Medicaid payment restrictions, entire bill HR 3533, Public and Teaching Hospital Preservation, Entire Bill HR 5613, Protectiosn for Medicaid Safety New Act of 2008, Entire Bill S 2819, Economical Recovery in Health Care Act of 2008, Entire Bill HR 4105, Medicare Recovery in Audit Contractor Program Moratorium Act of 2007, Entire Bill HR, 1424, Paul; Wellstone Mental Health and Addiction Equity Act of 2007, Section 106, Limitation on Physicain Ownership of Hospital. HR 1174, Health Hospital Act of 2007, Entire bil S 1842/HR 2122, Safe Nursing and Patient Care Act of 2007, entire bill, Social Sercutiy Incoem Days- Disporportionated Share Hospital Payments, Miscalculations of SSI Days by CMS.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.882 - Access to Emergency Medical Services Act of 2007 H.R.1093 - Resident Physician Shortage Reduction Act of 2007 H.R.1424 - Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.2050 - Medicaid Emergency Psychiatric Care Act of 2007 H.R.2164 Medicare Ambulance Payment Extension Act H.R.2749 Voluntary Medicare Quality Reporting Act H.R.3533 Public and Teaching Hospital Preservation Act H.R.4736 To amend Part B of Title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing H.R.5445 To amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physicians services through December 31, 2009 H.R.5613 Protecting the Medicaid Safety Net Act of 2008 S.588 Resident Physician Shortage Reduction Act of 2007 S.1003 Access to Emergency Medical Services Act of 2007 S.1310 Medicare Ambulance Payment Extension Act S.1408 Health Information Technology Act of 2007 S.1519 Voluntary Medicare Quality Reporting Act S.1947 Continuing the Advancement of Quality Improvement Act of 2007 S.2406 Medicaid Emergency Psychiatric Care Act of 2007 S.2729 Ensuring the Future Physician Workforce Act of 2008 S.2785 Save Medicare Act of 2008 S.2819 Economic Recovery in Health Care Act of 2008

Client expense: $762,281 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.477 Stroke Treatment & Ongoing Prevention Act H.R.583 Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 H.R.882 Access to Emergency Medical Services Act of 2007 H.R.1093 Resident Physician Shortage Reduction Act of 2007 H.R.1233 Mitigating the Impact of Uncompensated Services & Time Act of 2007 H.R.1418 Reauthorizations of the Traumatic Brain Injury Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.2050 Medicaid Emergency Psychiatric Care Act of 2007 H.R.2164 Medicare Ambulance Payment Extension Act H.R. 2406 Healthcare Information Technology Enterprise Integration Act H.R.2464 Wakefield Act H.R.2580 Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007 H.R.2583 Physician Workforce & Graduate Medical Education Enhancement Act of 2007 H.R.2584 High-need Physician Workforce Incentives Act of 2007 H.R.2626 Comprehensive Health Coverage and Reform Enhancement (CARE) Act of 2007 H.R.2749 Voluntary Medicare Quality Reporting Act H.R.3163 Healthy Americans Act H.R.3173 Improving Emergency Medical Care & Response Act of 2007 H.R.3344 Treat Physicians Fairly Act of 2007 H.R.3495 - Kids in Disasters Well-Being, Safety & Health Act of 2007 H.R.3533 Public and Teaching Hospital Preservation Act H.R.3963 Childrens Health Insurance Program Reauthorization Act of 2007 H.R.4736 To amend Part B of Title XVIII of the Social Security Act to repeal limiting charges under the Medicare Program for non-participating physicians and to preempt State laws that prohibit balance billing H.R.5445 To amend Part B of Title XVIII of the Social Security Act to increase Medicare payments for physicians services through December 31, 2009 H.R.5613 Protecting the Medicaid Safety Net Act of 2008 S.60 Wakefield Act S.243 Medical Care Access Protection (MCAP) Act of 2007 S.334 Healthy Americans Act S.558 Mental Health Parity Act of 2007 S.588 Resident Physician Shortage Reduction Act of 2007 S.793 Reauthorizations of the Traumatic Brain Injury Act S.999 Stroke Treatment & Ongoing Prevention Act S.1003 Access to Emergency Medical Services Act of 2007 S.1042 Consistency, Accuracy, Responsibility, & Excellence (CARE) in Medical Imaging & Radiation Therapy Act of 2007 S.1310 Medicare Ambulance Payment Extension Act S.1408 Health Information Technology Act of 2007 S.1519 Voluntary Medicare Quality Reporting Act S.1693 Wired for Health Care Quality Act S.1873 Improving Emergency Medical Care & Response Act of 2007 S.1947 Continuing the Advancement of Quality Improvement Act of 2007 S.1970 Kids in Disasters Well-Being, Safety & Health Act of 2007 S.2029 Physician Payments Sunshine Act of 2007 S.2319 National Trauma Center Stabilization Act of 2007 S.2406 Medicaid Emergency Psychiatric Care Act of 2007 S.2729 Ensuring the Future Physician Workforce Act of 2008 S.2785 Save Medicare Act of 2008 S.2819 Economic Recovery in Health Care Act of 2008

Client expense: $762,281 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Preventing Reductions to Medicaid Hospital Payments: Public and Teaching Hospital Preservation Act (HR 3533/S 2460), FY2008 Medicaid Intergovernmental Transfer/Cost Limit Regulations, FY2008 Medicaid Graduate Medical Education Proposed Rule, Protecting the Medicaid Safety Net Act of 2008 (HR 5613); Supplemental Appropriations Acts, 2008 (HR 2642); Increasing Medicare's Resident Limits: Resident Physician Shortage Reduction Act (HR 1093/S 588); Preventing Reductions of Medicare Payments to Anesthesiologists: Medicare Anesthesiology; Teaching Funding Restoration Act of 2007 (HR 2053/S 2056); Improving Cancer Treatment and Care under Medicare: Comprehensive Cancer Care Improvements Act of 2007 (HR 1078); Improving Delivery of Care to Children Under Medicaid: Children's Healthcare and Quality Act of 2007 (HR 2723, S 1226, S 2790); Medicare Value Based Purchasing, Medicare Physician Payments: Preventing a 10% Reduction in CY2008: Medicare Improvements for Patients and Providers Act of 2008 (HR 6331/S 3101); Preserving Access to Medicare Act of 2008 (S 3118); Maintaining Medicare Indirect Medical Education Payments. Increased Medicare Payments to Nurse-Midwives: Midwifery Care Access and Reimbursement Equity Act of 2007 (HR 864/S 507).

Client expense: $41,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

H.R. 6331/S. 3101 The Medicare Improvements for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. H.R. 1424 Paul Wellstone Mental Health Parity and Addiction Act, Section 106 in House Bill. S. 558 Mental Health Parity Act 2007, Entire Bill. H.R. 5998 Medicaid SCHIP Directive, Entire Bill. H.R. 6357 To amend the Public Health Service Act. S. 2819 Economical Recovery in Health Care Act of 2008, Entire Bill. H.R. 4105 RAC, Entire Bill. H.R. 5924 Emergency Nursing Supply Relief Act, Entire Bill. H.R. 5882 To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future, Entire Bill. H.R. 6163 Medicare Telehealth Enhancement Act of 2008, Entire Bill. H.R. 6966 Safeguarding Our Hospitals' Futures Act of 2008, Entire Bill. H.R. 7110 Job Creation and Unemployment Relief Act of 2008, Title III-FMAP. H.R. 7067 Quality FIRST, Entire Bill. H.R. 7241/S. 3656 Preserving Access to Healthcare Act of 2008, Entire Bill. H.R. 5613 Protect Medicaid Safety Net, Entire Bill. H.R. 5942 National Trauma Center Stabilization Act, Entire Bill. S. 3101 The Medicare Improvements for Patients and Providers Act, Rural Hospital provisions. H.R. 4355/S. 2460 To impose moratorium on certain Medicaid payment restrictions, Entire Bill. H.R. 3533 Public and Teaching Hospital Preservation Act, Entire Bill. H.R. 1174 Health Hospitals Act of 2007, Entire Bill. S. 1842/H.R. 2122 Safe Nursing and Patient Care Act of 2007, Entire Bill. S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, Entire Bill. H.R. 7241 Preserving Access to Heatlhcare (PATH) Act of 2008, Entire Bill. H.R. 7067 Quality First Act, Entire Bill.

Client expense: $30,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2586, State Fiscal Relief Act of 2008 (regarding state fiscal relief) H.R. 5613, Protecting the Medicaid Safety Net Act of 2008 S. 2819, Economic Recovery in Health Care Act of 2008 H.R.5268, To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes. S.2460/H.R. 3533, To extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S. 2578/ H.R. 5173, To temporarily delay application of proposed changes to Medicaid payment rules for case management and targeted case management services. S.1200, A bill to amend the Indian Health Care Improvement Act to revise and extend the Act (provisions relating to Medicaid ID requirements and moratorium on targeted case management regulations) HR 4355, A bill to impose a moratorium on certain Medicaid payment restrictions. H.R. 3963, Childrens Health Insurance Program Reauthorization Act of 2007 (veto override)

Client expense: $120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3222, Department of Defense Appropriations Act for Fiscal Year 2009 HR 2641, S 1751 Energy & Water Appropriations Act for Fiscal Year 2009 HR 3533 Public & Teaching Hospital Act 2009 HR 2606 304B Program Improvement & Integrity Act Labor, HHS and Education Appropriations Bill S 2319 - Trauma Center Stabilization Act H.R. 5426 - Direct Medical Education Payment Bill Economic Recovery and Stimulus legislation Surface Transportation Reauthorization legislation

Client expense: $127,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 4355/S 2460, To impose moratorium on certain Medicaid payment restrictions, Entire Bill. HR 3533, Public and Teaching Hospital Preservation Act, Entire Bill. HR 5613, Protecting the Medicaid Safety Net Act of 2008, Entire Bill. S 2819, Economical Recovery in Health Care Act of 2008, Entire Bill. HR 4105, Medicare Recovery in Audit Contractor Program Moratorium Act of 2007, Entire Bill. HR 1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007, Section 106 Limitation on Physician Ownership of Hospital. HR 1174, Health Hospitals Act of 2007, Entire Bill. S 1842/HR 2122, Safe Nursing and Patient Care Act of 2007, Entire Bill. Social Security Income Days-Disporportionate Share Hospital Payments, Miscalculation of SSI Days by CMS.

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals. Advocated for HR 5924 - Emergency Nursing Supply Relief Act; all provisions.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. Supplemental Appropriations Act, 2008 (HR 2642) Sec. 7001. (a) Moratoria on Certain Medicaid Regulations HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program HR 7110: Job Creation and Unemployment Relief Act: Title III, temporary increase in Medicaid matching rate S 3656: Preserving Access to Healthcare (PATH) Act -- which would delay cuts to Medicare capital indirect medical education (IME) payments for six months provisions in the developing economic stimulus package to temporarily increase FMAP self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce: HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program the Fiscal Year (FY) 2009 inpatient prospective payment system (IPPS) final rule eliminated indirect medical education (IME) adjustments to teaching hospitals' capital payments proposed rule to implement National Defense Authorization Act for Fiscal Year 2002" requirement that TRICARE payment methods for outpatient hospital care be determined outpatient reimbursement rules used by Medicare S 3656: to delay cuts to Medicare capital indirect medical education (IME) payments for six months quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

Client expense: $100,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, White House Office

S.458 Physician Pathology Continuity Act, S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas H.R. 6357 Protecting Records, Optimizing Treatment and Easing Communications through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Services Continuity Act, S. 558 The Mental Health Parity Act of 2007, S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act, S.969 Oppose Reversal of NLRB guidance on when charge nurses are classifed as supervisors, S.1041 Employee Free Choice Act-Oppose Card Check process, S.1604 Nursing Education and Quality of Health Care Act of 2007, S.1693 Health Information Exchange, S.2041 The False Claims Act Correction Act of 2007, S.2460 Extend S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers, S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007, S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP, S.3101 The Medicare Improvements for Patients and Providers Act S.3656 Preserving Access to Healthcare (PATH) Act of 2008 H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.2638 Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 continuing resolution 2009 H.R.2642, supplemental appropriations Act, 2008 H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5480 Medicare Funding Warning Response Act of 2008 H.R.5613 Extend and Establish Moratorium on Medicaid Rules H.R.5924 Emergency Nursing Supply Relief Act H.R.6331 Physician Medicare payment relief H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology H.R.6898 Health-e IT Act of 2008 H.R.7067 Quality FIRST Act of 2008 H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision H.R.7219 The Protecting Hospital Outpatient and Community Clinic Services Act of 2008 H.R.7241 Preserving Access to Healthcare (PATH) Act of 2008 H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas

Client expense: Not reported · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act-Oppose Card Check process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on medicaid regulations affecting intergovernmental transfers; S.2499 Medicare, medicaid, and SCHIP extension act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and establish moratorium on Medicaid rules; increase FMAP; S.3101 the Medicare improvements for patients and providers act; S.3656 Preserving access to healthcare (PATH) act of 2008; H.R.800 Employee free choice act (oppose card check process); H.R.866 Secret ballot protection act; H.R.976 Children's health insurance reauthoriation act of 2007; H.R.1105 Physician pathology services continuity act; H.R.1177 Sole commuunity hospital preservation act; H.R.1424 Paul Wellstone mental health and addiction equity act of 2007; H.R.1644 Oppose reversal of NLRB quidance on when charge nurses are classified as supervisors; H.R.1663 Medicare mental health modernization act of 2007; H.R.2159 Rural health services preservation act; H.R.2406 establishes NIST role in standard setting for health IT; H.R.2638 Consolidated security, disaster assistance, and continuing appropriations act, 2009; Continuing resolution 2009; H.R.2642 Supplemental appropriations act, 2008; H.R.3162 Children health and Medicare protection act of 2007; H.R.3326 Early treatment for HIV act; H.R.3533 Public and teaching hospital preservation Act; H.R.4105 One-year moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5480 Medicare funding warning response act of 2008; H.R.5613 Extend and establish moratorium on Medicaid rules; H.R.5924 Emergency nursing supply relief act; H.R.6331 Physician Medicare payment releif; H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology; H.R.6898 Health-E IT Act of 2008; H.R.7067 Quality FIRST Act of 2008; H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision; H.R.7219 the Protecting Hospital and outpatient and community clinic services act of 2008; H.R.7241 Preserving access to health care (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare prescription drug improvement and modernization act of 2003; FFY 2009 budget and budget resolutions/Medicare and Medicaid cuts; FFY 2009 Labor, health and human services, education and pension appropriations bill; FFY 2009 Medicare Inpatient hospital PPS rules; CY 2009 Medicare inpatient Psychiatric facility PPS rules; FFY 2009 Medicare inpatient rehabiltiation facility PPS and "75% rule," rules; CY 2009 Medicare otupatient PPS rules; FFY 2009 Medicare skilled nursing facility PPS rules; CY 2009 Medicare home health agency PPS rules; CY 2009 Medicare physician fee schedule update; CMS proposed rule to limit intergovernmental transfers and certified public expenditures; CMS proposed value-based purchasing program; CMS proposed rule on Medicad graduate medical education payments; State childrens health insurance program funding; IRS Form 990 revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; pay for performance/value based purchasing; health information technology; hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductibel health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; mental health parity; Limited service hospitals; Department of Housing and Urban Development's federal housing assistance mortage program for hospitals; Defiend benefit pension plans; National Institute of Health funding; Health care workforce recruting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340b drug pricing program; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; CMS directive to states establishing new requirements for increasing SCHIP coverage; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: $240,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (Medicare Improvement for Patients and Providers Act of 2008, H.R.6331, S.3101;CHAMP Act, H.R.3162;Preserving Access to Medicare Act of 2008,S.3118;Inpatient Medicare Prospective Payment System Rule, CMS 1390-P,F;Medicare Recovery Audit Contractor Program Moratorium Act of 2007, H.R.4105;Nursing and Allied Health Education Preservation Act of 2008;H.R.5174;Registered Nurse Safe Staffing Act of 2007, H.R.4138;42CFR413.75,H.R.1093,provisions related to Medicare graduate medical education and the counting of resident work hours, HR 615 & 616 relating to Medicare Parity; PATH Act of 2008 (S.3656, HR 7241) Medicaid reimbursement issues (Iraq War Supplemental Appropriations Bill, H.R. 2642-Provision to Place Moratoria on Medicaid Regulations CMS-2258-FC,CMS 2279-P,CMS 2213-P, and CMS-2275-F; Protecting the Medicaid safety Net Act of 2008, H.R.5613;Public and Teaching Hospital Preservation Act, H.R.3533;Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2007, H.R.2066;Temporary Increase in FMAP (HR5268,S.2586, H.R.7110, S. 3656,S.3689 ) Medicaid Outpatient Regulation (ms 2213-F)

Client expense: $360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 3533 and S. 2460; The Public and Teaching Hospital Preservation Act to extend the Medicaid Moratorium; Texas Demonstration to Maintain Independence and Employment; Sec. 204 of the Ticket to Work and Work Incentives Act; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medical and health care policy matters associated with post-Katrina disaster area adjustments for Medicare graduate medical education programs and hospital wage index mechanisms; and, health care redesign and reform initiatives in New Orleans and/or Louisiana area. Also supported the general stabilization of Medicare payments to physicians and hospitals. H.R. 5613 - Protecting the Medicaid Safety Net Act of 2008 S. 2460 - (Medicaid bill -Unnamed) To extend by one year the moratorium on implementation of a rule related to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program. S. 2819 - Economic Recovery in Health Care Act of 2008 H.R. 3533- The Public and Teaching Hospital Preservation Act - Supported extension of moratorium of Medicaid rules affecting the use of Medicaid funds to support programs of graduate medical education. S.2785- Save Medicare Act of 2008 - Supported the stabilization of Medicare payments to physicians and hospitals. H.R. 2642- Supplemental Appropriations Act, 2008 -Supported post-Katrina financial relief for New Orleans area hospitals, and extension of a moratorium on Medicaid rules affecting the use of Medicaid funds to support programs of graduate medical education. S.3101- The Medicare Improvement for Patients and Providers Act of 2008-Supported the stabilization of Medicare payments to physicians and hospitals. H.R. 6331- Medicare Improvements for Patients and Providers Act of 2008-Supported the stabilization of Medicare payments to physicians and hospitals. S. 3656- Preserving Access to Healthcare Act of 2008 - Supported the preservation of capital indirect medical education payments for teaching hospitals. Health care information technology and Medicare capital indirect medical education payments to teaching hospitals that may be part of the emerging 2009 economic stimulus legislation.

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE, White House Office

HR 3222, Department of Defense Appropriations Act for Fiscal Year 2009 HR 2641, S 1751 Energy & Water Appropriations Act for Fiscal Year 2009 HR 3533 Public & Teaching Hospital Act 2009 HR 2606 304B Program Improvement & Integrity Act Labor, HHS and Education Appropriations Bill S 2319 - Trauma Center Stabilization Act H.R. 5426 - Direct Medical Education Payment Bill Economic Recovery and Stimulus legislation Surface Transportation Reauthorization legislation

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 3/ HR 4 - Medicare Prescription Drug Price Negotiation Act of 2007 SCHIP Reauthorization Medicaid Regulations/Moratoria Federal Medical Assistance Percentage Increase HR 3533- The Public and Teaching Hospital Preservation Act HR 4355 - To impose a moratorium on certain Medicaid payment restrictions HR 5268/S 2620- To provide for a temporary increase of the Federal Medical Assistance Percentage under the Medicaid Program, and for other purposes

Client expense: $34,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

H.R. 6331/S. 3101 The Medicare Improvements for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. H.R. 1424 Paul Wellstone Mental Health Parity and Addiction Act, Section 106 in House Bill. S. 558 Mental Health Parity Act 2007, Entire Bill. H.R. 5998 Medicaid SCHIP Directive, Entire Bill. H.R. 6357 To amend the Public Health Service Act. S. 2819 Economical Recovery in Health Care Act of 2008, Entire Bill. H.R. 4105 RAC, Entire Bill. H.R. 5924 Emergency Nursing Supply Relief Act, Entire Bill. H.R. 5882 To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future, Entire Bill. H.R. 6163 Medicare Telehealth Enhancement Act of 2008, Entire Bill. H.R. 6966 Safeguarding Our Hospitals' Futures Act of 2008, Entire Bill. H.R. 7110 Job Creation and Unemployment Relief Act of 2008, Title III-FMAP. H.R. 7067 Quality FIRST, Entire Bill. H.R. 7241/S. 3656 Preserving Access to Healthcare Act of 2008, Entire Bill. H.R. 5613 Protect Medicaid Safety Net, Entire Bill. H.R. 5942 National Trauma Center Stabilization Act, Entire Bill. S. 3101 The Medicare Improvements for Patients and Providers Act, Rural Hospital provisions. H.R. 4355/S. 2460 To impose moratorium on certain Medicaid payment restrictions, Entire Bill. H.R. 3533 Public and Teaching Hospital Preservation Act, Entire Bill. H.R. 1174 Health Hospitals Act of 2007, Entire Bill. S. 1842/H.R. 2122 Safe Nursing and Patient Care Act of 2007, Entire Bill. S. 3656 Preserving Access to Healthcare (PATH) Act of 2008, Entire Bill. H.R. 7241 Preserving Access to Heatlhcare (PATH) Act of 2008, Entire Bill. H.R. 7067 Quality First Act, Entire Bill.

Client expense: $30,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Texas 1115 Waiver HR 3533/S2460 Public and Teaching Hospital Preservation Act all provisions HR 5613 - Protecting the Medicaid Safety Net Act of 2008 all provisions HR 3333/S1576 Minority Health Improvement and Health Disparity Elimination Act all provisions Medicare Improvements for Patients and Providers Act (P.L. 110-275) S 3656/HR 7241 Preserving Access to Healthcare (PATH) Act of 2008

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA)

Extending the Moratoria on the FY2008 Medicaid Intergovernmental Transfer/Cost Limit Regulations and the FY 2008 Medicaid Graduate Education Proposed Rule: Title VII of the "Supplemental Appropriations Act, 2008 (H.R. 2642), "Protecting the Medicaid Safety Net Act of 2008" (H.R. 5613), The Public and Teaching Hospital Preservation Act (H.R. 3533/S. 2400); Increasing Medicare's Resident Limits: Resident Physician Shortage Reduction Act (H.R. 1093/S. 588); Preventing Reductions of Medicare Payments to Anesthesiologists: Medicare Anesthesiology; Teaching Funding Restoration Act of 2007 (HR 2053/S 2056); Improving Cancer Treatment and Care under Medicare: Comprehensive Cancer Care Improvements Act of 2007 (HR 1078); Improving Delivery of Care to Children Under Medicaid: Children's Healthcare and Quality Act of 2007 (HR 2723, S 1226, S 2790); Medicare Value Based Purchasing; Medicare Physician Payments - Preventing a 10% Reduction in CY2008: Medicare Improvements for Patients and Providers Act of 2008 (HR 6331/S 3101); Preserving Access to Medicare Act of 2008 (S 3118); Maintaining Medicare Operating and Capital Indirect Medical Education Payments: Preserving Access to Heathcare (PATH) Act of 2008 (S 3656/HR 7241); Increased Medicare Payments to Nurse-Midwives: Midwifery Care Access and Reimbursement Equity Act of 2007 (HR 864/S 507).

Client expense: $62,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

H.R.882, Access to Emergency Medical Services Act of 2007, Quality and patient safety. H.R.1093/S.588, Resident Physician Shortage Reduction Act of 2007, Workforce shortage issues. S.543, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007, Health care issues. H.R.1376/H.R.2606, 340B Program Improvement and Integrity Act, Pharmaceutical related issues. H.R.5544, Patients and Public Health Partnership Act of 2008, Uninsured and medically underserved related issues. S.1693, Wired for Health Care Quality Act , Health information technology related issues. S.1814, Health Information Privacy and Security Act, Health information technology related issues. S.2319, National Trauma Center Stabilization Act of 2007, Emergency readiness and trauma related issues. H.R.5613, Protecting the Medicaid Safety Net Act of 2008, Medicaid regulations related issues. H.R.3533, Public and Teaching Hospital Preservation Act, GME and related issues. S.2460, A bill to extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a rule regarding graduate medical education under Medicaid and to include a moratorium on the finalization of the outpatient Medicaid rule making similar changes -- Medicaid related issues. H.R.4105, Medicare Recovery Audit Contractor Program Moratorium Act of 2007, RAC related issues. H.R.1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007, Mental health and addiction parity. S.1083/H.R.1930, Securing Knowledge, Innovation, and Leadership Act of 2007, Healthcare workforce shortage related issues. General monitoring of patient safety and quality issues.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R.5613, Protecting the Medicaid Safety Net Act of 2008, Medicaid regulations related issues. H.R.3533, Public and Teaching Hospital Preservation Act, GME and related issues. S.2460, A bill to extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a rule regarding graduate medical education under Medicaid and to include a moratorium on the finalization of the outpatient Medicaid rule making similar changes -- Medicaid related issues. H.R.4105, Medicare Recovery Audit Contractor Program Moratorium Act of 2007, RAC related issues.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

S.1693 -- The Wired for Health Care Quality Act H.R. 2606 - To Amend Section 340B of the Public Health Service Act H.R. 5605 - Physicians Payments Sunshine Act H.R. 3533 - Public and Teaching Hospital Prevention Act Healthcare Group Purchasing Value-Based Medicare Purchasing Healthcare Acquired Infections Inpatient Prospective Payment System Health Information Technology IVIG Average Sales Price for Part B Drugs Medicare, Medicaid and SCHIP S. 2313 - Strategies to Address Antimicrobial Resistance Act H.R. 3697 - Strategies to Address Antimicrobial Resistance Act Unique Device Identification H.R. 5613 - Protecting the Medicaid Safety Net of 2008 S. 2819 - Economic Recovery in Health Care Act of 2008 S. 2029 - Physician Payments Sunshine Act of 2007 S. 2460 - Extends Medicaid Moratorium H.R. 5442 - Trust in Health Information Act of 2008 S. 1814 - Health Information Privacy and Security Act H.R. 7067 - Quality First Act H.R. 6898 - Health-e Information Technology Act of 2008 S. 3656 - Preserving Access to Healthcare Act Physician Self-Referral H.R. 6331 - Medicare Improvements for Patients and Providers Act H. R. 6357 - Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 1424 - Emergency Economic Stabilization Act of 2008 Medicaid Outpatient Graduate Medical Education

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE

Economic Recovery in Health Care Act of 2008 (S. 2819) Medicare Recovery Audit Contractor Program Moratorium Act of 2007 (H.R. 4105) Preserving Access To Healthcare Act (PATH Act) (H.R. 7241/S. 3656) Public and Teaching Hospital Preservation Act (H.R. 3533) Section 1011 of the Medicare Modernization Act (MMA) (H.R. 6394) To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes. (H.R. 7110/S. 3604) 340B Program Improvement and Integrity Act of 2007 (H.R. 2606)

Client expense: $12,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3533 and S. 2460; The Public and Teaching Hospital Preservation Act to extend the Medicaid Moratorium; Texas Demonstration to Maintain Independence and Employment; Sec. 204 of the Ticket to Work and Work Incentives Act; H.R. 5613 Protecting the Medicaid Safety Net Act of 2008.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3222, Department of Defense Appropriations Act for Fiscal Year 2009 HR 2641, S 1751 Energy & Water Appropriations Act for Fiscal Year 2009 HR 3533 Public & Teaching Hospital Act 2009 HR 2606 304B Program Improvement & Integrity Act Labor, HHS and Education Appropriations Bill S 2319 - Trauma Center Stabilization Act H.R. 5426 - Direct Medical Education Payment Bill

Client expense: $90,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for HR 5445 - Social Security Act to increase Medicaid payment for physician services through December 31, 2009; all provisions. Advocated for HR 3533 - The Public and Teaching Hospital Preservation Act; all provisions. Advocated for HR 5613 - Protecting the Medicaid Safety Net Act of 2008; all provisions. Advocated for HR 2860 - The Healthcare Access and Rural Equity Act; all provisions. Advocated for HR 1424 - Paul Wellstone Mental Health and Addiction Equity Act of 2007; all provisions. Advocated for HR 2642 - Supplemental Appropration Act of 2008: Provisions relating to Medicaid payments to hospitals. Advocated for HR 6331 - Medicare Improvements for Patients and Providers Act of 2008: Provisions relating to Medicare Payments to Physicians and relating to rural hospitals. Advocated for HR 5924 - Emergency Nursing Supply Relief Act; all provisions.

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Title VII of the "Supplemental Appropriations Act, 2008 (H.R. 2642), "Protecting the Medicaid Safety Net Act of 2008" (H.R. 5613), The Public and Teaching Hospital Preservation Act (H.R. 3533/S. 2400): Extending the Moratoria on the FY2008 Medicaid Intergovernmental Transfer/Cost Limit Regulations and the FY 2008 Medicaid Graduate Education Proposed Rule; Increasing Medicare's Resident Limits: Resident Physician Shortage Reduction Act (H.R. 1093/S. 588); Preventing Reductions of Medicare Payments to Anesthesiologists: Medicare Anesthesiology; Teaching Funding Restoration Act of 2007 (HR 2053/S 2056); Improving Cancer Treatment and Care under Medicare: Comprehensive Cancer Care Improvements Act of 2007 (HR 1078); Improving Delivery of Care to Children Under Medicaid: Children's Healthcare and Quality Act of 2007 (HR 2723, S 1226, S 2790); Medicare Value Based Purchasing, Medicare Physician Payments: Preventing a 10% Reduction in CY2008: Medicare Improvements for Patients and Providers Act of 2008 (HR 6331/S 3101); Preserving Access to Medicare Act of 2008 (S 3118); Maintaining Medicare Operating and Capital Indirect Medical Education Payments. Increased Medicare Payments to Nurse-Midwives: Midwifery Care Access and Reimbursement Equity Act of 2007 (HR 864/S 507).

Client expense: $57,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

H.R.882, Access to Emergency Medical Services Act of 2007, Quality and patient safety. H.R.1093/S.588, Resident Physician Shortage Reduction Act of 2007, Workforce shortage issues. S.543, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007, Health care issues. H.R.1376/H.R.2606, 340B Program Improvement and Integrity Act, Pharmaceutical related issues. H.R.5544, Patients and Public Health Partnership Act of 2008, Uninsured and medically underserved related issues. S.1693, Wired for Health Care Quality Act , Health information technology related issues. S.1814, Health Information Privacy and Security Act, Health information technology related issues. S.2319, National Trauma Center Stabilization Act of 2007, Emergency readiness and trauma related issues. H.R.5613, Protecting the Medicaid Safety Net Act of 2008, Medicaid regulations related issues. H.R.3533, Public and Teaching Hospital Preservation Act, GME and related issues. S.2460, A bill to extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a rule regarding graduate medical education under Medicaid and to include a moratorium on the finalization of the outpatient Medicaid rule making similar changes -- Medicaid related issues. H.R.4105, Medicare Recovery Audit Contractor Program Moratorium Act of 2007, RAC related issues. H.R.1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007, Mental health and addiction parity. S.1083/H.R.1930, Securing Knowledge, Innovation, and Leadership Act of 2007, Healthcare workforce shortage related issues. General monitoring of patient safety and quality issues.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R.5613, Protecting the Medicaid Safety Net Act of 2008, Medicaid regulations related issues. H.R.3533, Public and Teaching Hospital Preservation Act, GME and related issues. S.2460, A bill to extend by one year the moratorium on implementation of a rule relating to the Federal-State financial partnership under Medicaid and the State Children's Health Insurance Program and on finalization of a rule regarding graduate medical education under Medicaid and to include a moratorium on the finalization of the outpatient Medicaid rule making similar changes -- Medicaid related issues. H.R.4105, Medicare Recovery Audit Contractor Program Moratorium Act of 2007, RAC related issues.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R.1093/S.588, Resident Physician Shortage Reduction Act of 2007, Workforce shortage issues. H.R.1952, National Health Information Incentive Act of 2007, Health IT issues. General monitoring of Medicare/Medicaid Reimbursement 340 B Program; and patient quality and safety. H.R.3533, Public and Teaching Hospital Preservation Act, GME related issues. H.R.4105, Medicare Recovery Audit Contractor Program Moratorium Act of 2007, RAC related issues. H.R.2606/S.1376, 340B Program Improvement and Integrity Act of 2007, Reimbursement related issues. H.R.4231, Rural Veterans Health Care Access Act of 2007, Veterans healthcare related issues. H.R.1424, Paul Wellstone Mental Health and Addiction Equity Act of 2007, Mental health and addiction parity.

Client expense: Not reported · Firm income: $20,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Texas 1115 Waiver HR 3533/S2460 Public and Teaching Hospital Preservation Act all provisions HR 5613 - Protecting the Medicaid Safety Net Act of 2008 all provisions HR 3333/S1576 Minority Health Improvement and Health Disparity Elimination Act all provisions Medicare Improvements for Patients and Providers Act (P.L. 110-275) S 3656/HR 7241 Preserving Access to Healthcare (PATH) Act of 2008

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA)

Legislation regarding Medicare and Medicaid Reimbursement issues which include provisions to expand access, improve services, stabilize payments to hospitals and other providers under Medicaid, Medicare, and/or SCHIP by addressing reimbursement, parity, quality, self-referral, workforce, payment issues, rehabilitation hospitals, long term care hospitals, rural hospitals and various regulations. HR 2055 Improving Children's Access to Health Care Act, to improve children's access to health care coverage under the Medicaid Program and the State Children's Health Insurance Program (SCHIP). HR 2606, 340B Drug Expansion Act of 2007, to revise and expand the drug discount program under that section to improve the provision of discounts on drug purchases for certain safety net providers. S 355, Social Security and Medicare Solvency Commission Act, to create a permanent, 15-member commission to make recommendations on how best to save the entitlement programs HR 4105; the Medicare Recovery Audit Contractor Program Moratorium Act of 2007 that would enact a one-year, nationwide moratorium on the Recovery Audit Contract (RAC) program. H Con Res 312/S Con Res 70, fiscal year (FY)2009 budget resolutions, Medicare and Medicaid reductions HR 5480/S 2662, Medicare Funding Warning Response Act, various provisions S 2785, Save Medicare Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index reclassification. S. 3101; Medicare Improvements for Patients and Providers physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6331, Medicare Improvements for Patients and Providers Act physician payment, exceptions process for therapy caps, direct billing by independent labs for pathology services, cost-based payment for rural lab services, and provisions allowing certain hospitals to be eligible for wage index HR 6252/S3144, would delay for 18 months the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies. Supplemental Appropriations Act, 2008 (HR 2642) Sec. 7001. (a) Moratoria on Certain Medicaid Regulations HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program HR 7110: Job Creation and Unemployment Relief Act: Title III, temporary increase in Medicaid matching rate S 3656: Preserving Access to Healthcare (PATH) Act -- which would delay cuts to Medicare capital indirect medical education (IME) payments for six months self-referral HR 1424; Paul Wellstone Mental Health and Addiction Equity Act provision banning the growth of physician-owned specialty hospitals workforce, HR3043/S1710; Labor, HHS Appropriations bill; nursing education, national health service corp, rural health programs, childrens hospitals GME, S 543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. HR 3162, "Children's Health and Medicare Protection Act" payment: HR 2206, U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act supplemental appropriations bill (HR 2206) contained moratorium on medicaid regulations regarding capping payment to public providers and GME HR 1480/1741/S 787, to place a two-year moratorium on the Centers for Medicare & Medicaid Services implementation of medicaid regulations regarding capping payment to public providers and GME funding from Section 1011 of the Medicare Modernization Act of 2003 (MMA), HR 1293, Access to Medicare Imaging Act stop the reduction Medicare reimbursements for some medical imaging services HR 882, Access to Emergency Services Act that would increase by 10 percent Medicare reimbursements to physicians who provide care in emergency departments (EDs) or post-stabilization care related to emergency medical conditions in other areas of hospitals HR 552/S 329, The Pulmonary and Cardiac Rehabilitation Act of 2007 to provide for coverage of items and services under a cardiac rehabilitation program and a pulmonary rehabilitation program. HR 3533/S2460, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 3668, TMA, Abstinence Education, and QI Programs Extension Act includes provision which would mitigate the impact of the behavioral offset in the FY08 Inpatient Prospective Payment System (IPPS) final rule S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals, Section 508 hospitals HR 5268: To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program quality S 1226, Children's Health Care Quality Act would allow the Centers for Medicare & Medicaid Services to fund evidence-based demonstrations to improve hospital care for children. HR 1666, Health Care Price Transparency Promotion Act which would build on existing state efforts to report hospital pricing data and require insurers to disclose estimated out-of-pocket costs to consumers S 465; Advance Directives Improvement and Education Act of 2007" to improve access to information about healthcare options and legal rights for care near the end of life rehabilitation hospitals, S543/HR 1459, Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"; to extend the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program S 2499; Medicare, Medicaid, and SCHIP Extension Act Permanently freezes the inpatient rehabilitation services compliance threshold at 60 percent, rural hospitals, S 1605/HR 2860, Health Care Access and Rural Equity Act (H-CARE) S 1595, Critical Access Hospital Flexibility Act CAHs would gain flexibility to respond to daily and seasonal fluctuations in patient load S 2499;; Medicare, Medicaid, and SCHIP Extension Act Extends for six months the work geographic index floor, for six months the provision that allows independent laboratories to continue to bill Medicare directly for the technical component of certain physician pathology services, Provides reasonable cost reimbursement for clinical lab tests performed by certain small rural hospitals long term care hospitals: HR 562/S338, Medicare Long-Term Care Hospital Improvement establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. S 2499; Medicare, Medicaid, and SCHIP Extension Act Provides regulatory relief for three years to ensure continued access to current long-term care hospital services, while also imposing a limited moratorium on the development of new, long-term care facilities. Medicaid, HR 2512, Reducing Coverage Gaps for Kids Act To amend titles XIX and XXI of the Social Security Act to prohibit States from requiring eligibility determinations for children for benefits under the Medicaid Program and the State Children's Health Insurance Program (SCHIP) more frequently than once every year. HR 2147, Healthy Kids Act to amend titles XXI and XIX of the Social Security Act to extend the State Children's Health Insurance Program (SCHIP) and streamline enrollment under SCHIP and Medicaid and to amend the Internal Revenue Code of 1986 to provide for a healthy savings tax credit for purchase of children's health coverage. HR1111, Kids Come First Act to ensure that every uninsured child in America has health insurance coverage, HR 1878, To amend title XIX of the Social Security Act to permit States, at their option, to require certain individuals to present satisfactory documentary evidence of proof of citizenship or nationality for purposes of eligibility for Medicaid HR 3533/S2460 "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME HR 5613, Protecting the Medicaid Safety Net Act, temporary, one-year moratorium on seven Medicaid regulations S 2819, Economic Recovery in Health Care Act to implement a one-year moratorium on proposed regulatory changes to Medicaid and the State Childrens Health Insurance Program (SCHIP), and to provide states in need with federal relief HR 2462, the supplemental funding bill for Iraq and Afghanistan provision to place a temporary, one-year moratorium on seven Medicaid regulations, including the rules to limit Medicaid payments to public hospitals and to eliminate Government Medical Education (GME). SCHIP: S 1224, that would reauthorize the State Childrens Health Insurance Program and expand it to allow additional coverage to six million children within 10 years S 895/HR 1535, HR 3162, "Children's Health and Medicare Protection Act" HR 976 in the Senate, Children's Health Insurance Program Reauthorization Act S. 1893, the Children's Health Insurance Program Reauthorization Act of 2007 S 2049, The Better Health for America's Children Act," to block a new policy to limit states' ability to enroll children in the State Children's Health Insurance Program S 2152, Kids First Actalternative SCHIP bill that would restrict coverage to individuals younger than age 19 in low-income families HR 3963; Children's Health Insurance Program Reauthorization Act revised bill to extend and expand the State Childrens Health Insurance Program (SCHIP) S 2499 the bill extends SCHIP through March 31, 2009, and provides adequate funding to states to maintain their current enrollment through that date. HR 3533, "Public & Teaching Hospital Preservation Act" to extend a moratorium prohibiting CMS from implementing the Medicaid proposed rule that would limit Medicaid payments to public hospitals and narrow the definition of government provider and eliminate Medicaid GME regulations including, but not limited to, provisions of PL 106-554, Consolidated Appropriations Act, provisions related to critical access hospitals, inpatient hospital services Direct Graduate Medical Education, Hospital Outpatient Services, Skilled Nursing Facilities, State Children's Health Insurance Program PL 108-173, Medicare Prescription Drug, Improvement, and Modernization Act, provisions related to rural hospitals, inpatient hospital services, skilled nursing facilities, hospice care, hospital outpatient departments, health care quality PL 109-171; Deficit Reduction Act, provisions related to rehabilitation hospitals, medicaid DSH payment, medicare-dependent hospitals, gainsharing, Medicaid, SHCHIP the FY08 IPPS proposed rule, proposed Medicaid rule (CMS 2258-P), the Recovery Audit Contract (RAC) demonstration.

Client expense: $100,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, White House Office

S.1693 -- The Wired for Health Care Quality Act H.R. 2606 - To Amend Section 340B of the Public Health Service Act H.R. 5605 - Physicians Payments Sunshine Act H.R. 3533 - Public and Teaching Hospital Prevention Act Healthcare Group Purchasing Value-Based Medicare Purchasing Healthcare Acquired Infections Inpatient Prospective Payment System Health Information Technology IVIG Average Sales Price for Part B Drugs Medicare, Medicaid and SCHIP S. 2313 - Strategies to Address Antimicrobial Resistance Act H.R. 3697 - Strategies to Address Antimicrobial Resistance Act Unique Device Identification H.R. 5613 - Protecting the Medicaid Safety Net of 2008 S. 2819 - Economic Recovery in Health Care Act of 2008 S. 2029 - Physician Payments Sunshine Act of 2007 S. 2460 - Extends Medicaid Moratorium H.R. 5442 - Trust in Health Information Act of 2008 S. 1814 - Health Information Privacy and Security Act H.R. 7067 - Quality First Act H.R. 6898 - Health-e Information Technology Act of 2008 S. 3656 - Preserving Access to Healthcare Act Physician Self-Referral H.R. 6331 - Medicare Improvements for Patients and Providers Act H. R. 6357 - Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act H.R. 1424 - Emergency Economic Stabilization Act of 2008

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Office of Management & Budget (OMB), SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; S.1041 Employee Free Choice Act-Oppose Card Check process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on medicaid regulations affecting intergovernmental transfers; S.2499 Medicare, medicaid, and SCHIP extension act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and establish moratorium on Medicaid rules; increase FMAP; S.3101 the Medicare improvements for patients and providers act; S.3656 Preserving access to healthcare (PATH) act of 2008; H.R.800 Employee free choice act (oppose card check process); H.R.866 Secret ballot protection act; H.R.976 Children's health insurance reauthoriation act of 2007; H.R.1105 Physician pathology services continuity act; H.R.1177 Sole commuunity hospital preservation act; H.R.1424 Paul Wellstone mental health and addiction equity act of 2007; H.R.1644 Oppose reversal of NLRB quidance on when charge nurses are classified as supervisors; H.R.1663 Medicare mental health modernization act of 2007; H.R.2159 Rural health services preservation act; H.R.2406 establishes NIST role in standard setting for health IT; H.R.2638 Consolidated security, disaster assistance, and continuing appropriations act, 2009; Continuing resolution 2009; H.R.2642 Supplemental appropriations act, 2008; H.R.3162 Children health and Medicare protection act of 2007; H.R.3326 Early treatment for HIV act; H.R.3533 Public and teaching hospital preservation Act; H.R.4105 One-year moratorium on the Recovery Audit Contractor (RAC) program; H.R.4854 False Claims Act Correction Act of 2007; H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R.5480 Medicare funding warning response act of 2008; H.R.5613 Extend and establish moratorium on Medicaid rules; H.R.5924 Emergency nursing supply relief act; H.R.6331 Physician Medicare payment releif; H.R.6357 Protecting records, optimizing treatment, and easing communication through healthcare technology; H.R.6898 Health-E IT Act of 2008; H.R.7067 Quality FIRST Act of 2008; H.R.7110 Job Creation and Unemployment Relief Act of 2008-FMAP Provision; H.R.7219 the Protecting Hospital and outpatient and community clinic services act of 2008; H.R.7241 Preserving access to health care (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare prescription drug improvement and modernization act of 2003; FFY 2009 budget and budget resolutions/Medicare and Medicaid cuts; FFY 2009 Labor, health and human services, education and pension appropriations bill; FFY 2009 Medicare Inpatient hospital PPS rules; CY 2009 Medicare inpatient Psychiatric facility PPS rules; FFY 2009 Medicare inpatient rehabiltiation facility PPS and "75% rule," rules; CY 2009 Medicare otupatient PPS rules; FFY 2009 Medicare skilled nursing facility PPS rules; CY 2009 Medicare home health agency PPS rules; CY 2009 Medicare physician fee schedule update; CMS proposed rule to limit intergovernmental transfers and certified public expenditures; CMS proposed value-based purchasing program; CMS proposed rule on Medicad graduate medical education payments; State childrens health insurance program funding; IRS Form 990 revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; pay for performance/value based purchasing; health information technology; hospital charity care/financial aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductibel health plans; Emergency preparedness; Immigration; Medicare wage index; Community benefit reporting; mental health parity; Limited service hospitals; Department of Housing and Urban Development's federal housing assistance mortage program for hospitals; Defiend benefit pension plans; National Institute of Health funding; Health care workforce recruting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of the Medicaid 340b drug pricing program; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; CMS directive to states establishing new requirements for increasing SCHIP coverage; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas.

Client expense: $220,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Economic Recovery in Health Care Act of 2008 (S. 2819) Medicare Recovery Audit Contractor Program Moratorium Act of 2007 (H.R. 4105) Public and Teaching Hospital Preservation Act (H.R. 3533) Section 1011 of the Medicare Modernization Act (MMA) (H.R. 6394) To provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program, and for other purposes. (H.R. 7110/S. 3604) 340B Program Improvement and Integrity Act of 2007 (H.R. 2606) Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331)

Client expense: $12,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6331/S. 3101 The Medicare Improvements for Patients and Providers Act, Sections 121, 122, 123, 124, 131, 132, 135, 145, 149, 150, 151, 161, 205. H.R. 1424 Paul Wellstone Mental Health Parity and Addiction Act, Section 106 in House Bill. S. 558 Mental Health Parity Act 2007, Entire Bill. H.R. 5998 Medicaid SCHIP Directive, Entire Bill. H.R. 6357 To amend the Public Health Service Act. S. 2819 Economical Recovery in Health Care Act of 2008, Entire Bill. H.R. 4105 RAC, Entire Bill. H.R. 5924 Emergency Nursing Supply Relief Act, Entire Bill. H.R. 5882 To recapture employment-based immigrant visas lost to bureaucratic delays and to prevent losses of family-and employment-based immigrant visas in the future, Entire Bill. H.R. 6163 Medicare Telehealth Enhancement Act of 2008, Entire Bill. H.R. 6966 Safeguarding Our Hospitals' Futures Act of 2008, Entire Bill. H.R. 7110 Job Creation and Unemployment Relief Act of 2008, Title III-FMAP. H.R. 7067 Quality FIRST, Enire Bill. H.R. 7241/S. 3656 Preserving Access to Healthcare Act of 2008, Entire Bill. H.R. 5613 Protect Medicaid Safety Net, Entire Bill. H.R. 5942 National Trauma Center Stabilization Act, Entire Bill. S 3101 The Medicare Improvements for Patients and Providers Act, Rural Hospital provisions. H.R. 4355/S. 2460 To impose moratorium on certain Medicaid payment restrictions, Entire Bill. H.R. 3533 Public and Teaching Hospital Preservation Act, Entire Bill. H.R. 1174 Health Hospitals Act of 2007, Entire Bill. S 1842/H.R. 2122 Safe Nursing and Patient Care Act of 2007, Entire Bill.

Client expense: $60,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.458 Physician Pathology Continuity Act, S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act, S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors, S.1041 Employee Free Choice Act - Oppose Card Check process S.1604 Nursing Education and Quality of Health Care Act of 2007 S.1693 Health Information Exchange S.2041 The False Claims Act Correction Act of 2007 S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers S.2499 Medicare, Medicaid, and SCHIP Extension Act of 2007 S.2620 Temporary increase in federal medical assistance percentages under Medicaid program S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP H.R.800 Employee Free Choice Act Oppose Card Check process H.R.866 Secret Ballot Protection Act H.R.976 Childrens Health Insurance Reauthorization Act of 2007 H.R.1105 Physician Pathology Services Continuity Act H.R.1177 Sole Community Hospital Preservation Act H.R.1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007 H.R.1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors H.R.1663 Medicare Mental Health Modernization Act of 2007 H.R.2159 rural Health Services Preservation Act H.R.2406 Establishes NIST Role in Standard Setting for Health IT H.R.3162 Children Health and Medicare Protection Act of 2007 H.R.3326 Early Treatment for HIV Act H.R.3533 Public and Teaching Hospital Preservation Act, H.R.4105 One-year Moratorium on the Recovery Audit Contractor (RAC) program H.R.4854 False Claims Act Correction Act of 2007 H.R.5268 Temporary increase in federal medical assistance percentages under Medicaid program H.R.5613 Extend and Establish Moratorium on Medicaid Rules FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations bill FFY 2009 Medicare Inpatient Hospital PPS Rules CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and 75% Rule, Rules CY 2009 Medicare Outpatient PPS Rules FFY 2009 Medicare Skilled Nursing Facility PPS Rules CY 2009 Medicare Home Health Agency PPS Rules CY 2009 Medicare Physician Fee Schedule Update CMS Proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures CMS Proposed Value-Based Purchasing Program CMS Proposed Rule on Medicaid Graduate Medical Education Payments State Childrens Health Insurance Program funding IRS Form 990 Revision Stark and physician self-referral regulations Hospital pricing transparency Not-for-profit hospital tax-exempt status Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health Pay for Performance / value based purchasing Health information technology Hospital charity care/financial aid Coverage for undocumented immigrants Associated health plans Coverage for the uninsured Health savings accounts and high-deductible health plans Emergency preparedness Immigration Medicare wage index Community benefit reporting Mental health parity Limited service hospitals Department of Housing and Urban Developments Federal Housing Assistance mortgage program for hospitals Defined benefit pension plans National Institute of Health funding Health care workforce recruiting and training funding Hospital infection reporting Medical error reporting Hospital performance measure reporting Medicare Recovery Audit Contractor Demonstration Project/national expansion Competitive bidding for clinical laboratory services Expansion of the Medicaid 340B drug pricing program CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage False claims act expansion Medicare funding warning/trigger Medicare GME residency slot distribution National Health Service Corp funding Public Health Service Act nursing and allied health professions program funding HRSAs health professions shortage areas and medically underserved areas H.R. 6357 Protecting Records, Optimizing Treatment and Easing Communications through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008 H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 H.R. 2642 Supplemental Appropriations Act, 2008

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB)

S 3/ HR 4 - Medicare Prescription Drug Price Negotiation Act of 2007 SCHIP Reauthorization Medicaid Regulations/Moratoria Federal Medical Assistance Percentage Increase HR 3533- The Public and Teaching Hospital Preservation Act HR 4355 - To impose a moratorium on certain Medicaid payment restrictions HR 5268/S 2620- To provide for a temporary increase of the Federal Medical Assistance Percentage under the Medicaid Program, and for other purposes HR 5613- Protecting the Medicaid Safety Net Act of 2008 HR 2642-Military Construction and Veterans Affairs Appropriations Act, 2008 HR 6331- Medicare Improvements for Patients and Providers Act of 2008

Client expense: $51,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), SENATE, State, Dept of (DOS), White House Office

Medicare hospital reimbursement issues and Medicare graduate medical education reimbursement issues (Medicare Improvement for Patients and Providers Act of 2008, H.R.6331, S.3101;CHAMP Act, H.R.3162;Preserving Access to Medicare Act of 2008, S.3118;Inpatient Medicare Prospective Payment System Rule, CMS 1390-P,F;Medicare Recovery Audit Contractor Program Moratorium Act of 2007, H.R.4105;Nursing and Allied Health Education Preservation Act of 2008;H.R.5174;Registered Nurse Safe Staffing Act of 2007, H.R.4138;42 CFR 413.75,H.R.1093,provisions related to Medicare graduate medical education and the counting of resident work hours,HR 615 & 616 relating to Medicare Parity Medicaid reimbursement issues (Iraq War Supplemental Appropriations Bill, H.R.2642-Provision to Place Moratoria on Medicaid Regulations CMS-2258-FC,CMS 2279-P,CMS 2213-P, and CMS-2275-F;Protecting the Medicaid Safety Net Act of 2008, H.R.5613;Public and Teaching Hospital Preservation Act, H.R.3533;Medicaid Advanced Practice Nurses and Physician Assistants Access Act of 2007, H.R.2066;Temporary Increase in FMAP (HR5268, S.2586, H.R.7110, S. 3656)

Client expense: $360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S.458 Physician Pathology Services Continuity Act; S.558 The Mental Health Parity Act of 2007; S.630 Rural Health Services Preservation Act; S.860 Early Treatment for HIV Act; S.969 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors;S.1041 Employee Free Choice Act-Oppose Card Check Process; S.1604 Nursing Education and Quality of Health Care Act of 2007; S.1693 Health Information Exchange; S.2041 The False Claims Act Correction Act of 2007; S.2460 Extend Moratorium on Medicaid Regulations affecting Intergovernmental Transfers; S.2499 Medicare, Medicaid and SCHIP Extension Act of 2007; S.2620 Temporary increase in federal medical assistance percentages under Medicaid program; S.2819 Extend and Establish Moratorium on Medicaid Rules; increase FMAP; H.R. 800 Employee Free Choice Act-Oppose Card Check Process; H.r. 866 Secret Ballot Protection Act; H.R. 976 Children's Health Insurance Reauthorization Act of 2007; H.R. 1105 Physician Pathology Services Continuity Act; H.R. 1177 Sole Community Hospital Preservation Act; H.R. 1424 Paul Wellstone Mental Health & Addiction Equity Act of 2007; H.R. 1644 Oppose reversal of NLRB guidance on when charge nurses are classified as supervisors; H.R. 1663 Medicare Mental Health Modernization Act of 2007; H.R. 2159 Rural Health Services Preservation Act; H.R. 2406 Establishes NIST Role in Standard Setting for Health IT; H.R. 2642 Supplemental Appropriations Act, 2008; H.R. 3162 Children's Health and Medicare Protection Act of 2007; H.R. 3326 Early Treatment for HIV Act; H.R. 3533 Public and Teaching Hospital Preservation Act; H.R. 4105 One-Year Moratorium on the Recovery Audit Contractor (RAC) Program; H.R. 4854 False Claims Act Correction Act of 2007; H.R. 5268 Temporary increase in federal medical assistance percentages under Medicaid program; H.R. 5613 Extend and Establish Moratorium on Medicaid Rules; HR. 6331 Physician Medicare Payment Relief; H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008; FFY 2009 Budget and Budget Resolutions/Medicare and Medicaid Cuts; FFY 2009 Labor, Health and Human Services, Education and Pension Appropriations Bill; FFY 2009 Medicare Inpatient Hospital PPS Rules; CY 2009 Medicare Inpatient Psychiatric Facility PPS Rules; FFY 2009 Medicare Inpatient Rehabilitation Facility PPS and "75% Rule", Rules; CY 2009 Medicare Outpatient PPS Rules; FFY 2009 Medicare Skilled Nursing Facility PPS Rules; CY 2009 Medicare Home Health Agency PPS Rules; CY 2009 Medicare Physician Fee Schedule Update; CMS proposed Rule to Limit Intergovernmental Transfers and Certified Public Expenditures; CMS Proposed Value-Based Purchasing Program; CMS Proposed Rule on Medicaid Graduate Medical Education Payments; State Childrens Health Insurance Program Funding; IRS Form 990 Revision; "Stark" and physician self-referral regulations; Hospital pricing transparency; Not-for-profit hospital tax-exempt status; Medicaid regulations affecting public hospitals, GME, provider tax, outpatient coverage, targeted case management, rehabilitation and school based health; Pay for Performance/Value Based Purchasing; Health Information Technology; Hospital Charity Care/Financial Aid; Coverage for undocumented immigrants; Associated health plans; Coverage for the uninsured; Health savings accounts and high-deductible health plans; Emergency preparedness; Immigration, Medicare wage index; Community benefit reporting; Mental health parity; Limited service hospitals; Department of Housing and Urban Development's Federal Housing Assistance Mortgage program for Hospitals; Defined benefit pension plans; National Institute of Health funding; Health care workforce recruiting and training funding; Hospital infection reporting; Medical error reporting; Hospital performance measure reporting; Medicare Recovery Audit Contractor Demonstration Project/national expansion; Competitive bidding for clinical laboratory services; Expansion of Medicaid 340B drug pricing program; CMS August 17th directive to states establishing new requirements for increasing SCHIP coverage; False claims act expansion; Medicare funding warning/"trigger"; Medicare GME residency slot distribution; National Health Service Corp. funding; Public Health Service Act nursing and allied health professions program funding; HRSA's health professions shortage areas and medically underserved areas; S.3101 The Medicare Improvements for Patients and Providers Act; S.3656 Preserving Access to Healthcare (PATH) Act of 2008; H.R. 2638 Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009 (continuing resolution 2009); H.R. 5480 Medicare Funding Warning Response Act of 2008; H.R. 5924 Emergency Nursing Supply Relief Act; H.R. 6898 Health-e IT Act of 2008; HR. 7067 Quality FIRST Act of 2008; H.R. 7110 Job Creation and Unemployment Relief Act of 2008 (Title III includes FMAP provision); H.R. 7219 The Protecting Hospital Outpatient and Community Clinic Services Act of 2008; H.R. 7241 Preserving Access to Healthcare (PATH) Act of 2008; H.Res.1368 Relating to the House procedures contained in Section 803 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Client expense: Not reported · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE